Reference intervals of D-dimer during the pregnancy and puerperium period on the STA-R evolution coagulation analyzer

Wang, Min; Lü, Shiming; Li, Shuai; Shen, Fengxian

doi:10.1016/j.cca.2013.08.006

Cited by 50 publications

(51 citation statements)

References 19 publications

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“…This suggests that D-dimer has no practical diagnostic use in pregnancy if the threshold for abnormal of 0.55 mg/L is used (cut-off out of pregnancy). The obtained results from this study are in accordance with our previously reported study and studies that included different population of pregnant women [14][15][16][17][18].…”

Section: Discussionsupporting

confidence: 92%

“…However, investigation of D-dimer among healthy pregnant women in different populations showed gradual increase of D-dimer which correlates with the gestational age; however, reference range varied depending on the D-dimer test (type, its sensitivity and specificity) [14][15][16][17][18], while the data about thrombin generation in normal pregnancy were scarce and conflicting [19,20].…”

Section: Introductionmentioning

confidence: 99%

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Thrombin generation, D-dimer and protein S in uncomplicated pregnancy

Kovač¹,

Lalic-Cosic

Dmitrovic³

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Thrombin generation, D-dimer and protein S in uncomplicated pregnancy

Kovač¹,

Lalic-Cosic

Dmitrovic³

et al. 2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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“…Whereas in the fi rst trimester, 50 -85 % of pregnant women have normal D-dimer levels, the proportion of women with values within the reference range decreases to 23 -33 % in the second trimester and to 0 -4 % in the third trimester [110,118,119]. Table V summarises the D-dimer ranges in recent studies sorted by trimester.…”

Section: D-dimer Testingmentioning

confidence: 99%

Diagnosis of pregnancy-associated venous thromboembolism - position paper of the Working Group in Women’s Health of the Society of Thrombosis and Haemostasis (GTH)

Linnemann¹,

Scholz

Rott

et al. 2016

Vasa

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EpidemiologyVTE is a leading cause of maternal morbidity in the developed world and, in the case of PE, of mortality as well [1]. While the relative risk of VTE is greatly increased during pregnancy compared with that in non-pregnant women, the absolute risk remains low: estimates of the incidence of pregnancy-associated VTE have varied from 1:500 to 1:1500 pregnancies [2 -7]. The risk of VTE is approximately 5-fold greater in pregnant women than in non-pregnant women.Approximately 80 % of pregnancy-associated VTEs are isolated DVTs, and approximately 20 % are PEs or both DVTs and PEs [5]. Although a systematic review reported weighted event rates for DVT of 21.9 %, 33.7 % and 47.6 % for the fi rst, second and third trimesters, respectively [6], a recent study suggested that the risk might in fact increase exponentially over the duration of the pregnancy [7], with 12.4 % of VTEs diagnosed in the fi rst trimester, 15.3 % in the second trimester and 72.3 % in the third trimester. This detailed risk assessment for each gestational week demonstrated a 21-fold increased risk for the last two weeks before delivery [7]. Summary: Pregnancy and the postpartum period are associated with an increased risk of venous thromboembolism (VTE). Over the past decade, new diagnostic algorithms have been established, combining clinical probability, laboratory testing and imaging studies for the diagnosis of deep vein thrombosis (DVT) and pulmonary embolism (PE) in the non-pregnant population. However, there is no such generally accepted algorithm for the diagnosis of pregnancy-associated VTE. Studies establishing clinical prediction rules have excluded pregnant women, and prediction scores currently in use have not been prospectively validated in pregnancy or during the postpartum period. D-dimers physiologically increase throughout pregnancy and peak at delivery, so a negative D-dimer test result, based on the reference values of non-pregnant subjects, becomes unlikely in the second and third trimesters. Imaging studies therefore play a major role in confi rming suspected DVT or PE in pregnant women. Major concerns have been raised against radiologic imaging because of foetal radiation exposure, and doubts about the diagnostic value of ultrasound techniques in attempting to exclude isolated iliac vein thrombosis grow stronger as pregnancy progresses. As members of the Working Group in Women's Health of the Society of Thrombosis and Haemostasis (GTH), we summarise evidence from the available literature and aim to establish a more uniform strategy for diagnosing pregnancy-associated VTE. Review Diagnosis of pregnancy-associated

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“…D‐dimer levels rise steadily during pregnancy . Studies have reported D‐dimer levels above the non‐pregnancy threshold in 15–50% of women in first trimester, 67–78% in second trimester and 96–100% in third trimester . D‐dimer levels are markedly elevated during labour, decreasing rapidly during the first 3 days post‐delivery, though normalisation may not occur until 4 weeks postpartum .…”

Section: Laboratory Investigationsmentioning

confidence: 99%

“…136,137 Studies have reported D-dimer levels above the non-pregnancy threshold in 15-50% of women in first trimester, 67-78% in second trimester and 96-100% in third trimester. [137][138][139] D-dimer levels are markedly elevated during labour, decreasing rapidly during the first 3 days post-delivery, though normalisation may not occur until 4 weeks postpartum. 140 Pregnancy-specific Ddimer thresholds have been suggested; however, validated cut-offs for the exclusion of thromboembolic disease are lacking.…”

Section: Measures Of Coagulopathymentioning

confidence: 99%

Review article: Investigations and the pregnant woman in the emergency department – part 1: Laboratory investigations

Morton

Teasdale

2018

Emerg Medicine Australasia

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Accurate assessment of the pregnant patient in the ED depends on knowledge of physiological changes in pregnancy, and how these changes may impact on pathology tests, appearance on point‐of‐care ultrasound and electrocardiography. In addition the emergency physician needs to be cognisant of disorders that are unique to or more common in pregnancy. Part 1 of this review addresses potential deviations in laboratory investigation reference intervals resulting from physiological alterations in pregnancy, and the important causes of abnormal laboratory results in pregnancy. Part 2 will address the role of point‐of‐care ultrasound in pregnancy, physiological changes that may affect interpretation of point‐of‐care ultrasound, physiological changes in electrocardiography, and the safety of radiological procedures in the pregnant patient.

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Reference intervals of D-dimer during the pregnancy and puerperium period on the STA-R evolution coagulation analyzer

Cited by 50 publications

References 19 publications

Thrombin generation, D-dimer and protein S in uncomplicated pregnancy

Thrombin generation, D-dimer and protein S in uncomplicated pregnancy

Diagnosis of pregnancy-associated venous thromboembolism - position paper of the Working Group in Women’s Health of the Society of Thrombosis and Haemostasis (GTH)

Review article: Investigations and the pregnant woman in the emergency department – part 1: Laboratory investigations

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